Objective To compare heterotopic ossification between femoral head reconstruction and total hip arthroplasty(THA) in patients with ischemic necrosis of femoral head(INFH). Methods Between June 1994 and December 2004, the femoral heads were repaired in 1 005 patients with INFH,the total hip was replaced in 485 patients with INFH. The rate of heterotopic ossification was observed in 74 (Ficat Ⅲ to Ⅳ stages) of 1 005 patients and 80 of 485 patients given THA to compared the results of the two methods. Results These patients were followed up 2 to 10 years(6.5 years on average). The rates of heterotopic ossification were 5.4%(4/74) and 22.5%(18/80), respectively. There was statistically significant difference between two operative methods (Plt;0.01). Conclusion The rate of heterotopic ossification of femoral head reconstruction is lower than that of THA, so femoral head reconstruction is a better operative method for young patients and THA is suitable for old patients.
Objective To evaluate the characterization, biocompatibil ity in vitro and in vivo, and antimicrobial activity of an injectable vancomycin-loaded borate glass/chitosan composite (VBC) so as to lay the foundation for its further cl inical application. Methods The sol id phase of VBC was constituted by borate glass and vancomycin, liquid phase was a mixture of chitosan, citric acid, and glucose with the proportion of 1 ∶ 10 ∶ 20. Solid phase and liquid phase was mixed withthe ratio of 2 ∶ 1. Vancomycin-loaded calcium sulfate (VCS) was produced by the same method using calcium sulfate instead of borate glass and sal ine instead of chitosan, as control. High performance liquid chromatography was applied to detect the release rate of antibiotics from VBC and VCS, and minimum inhibitory concentration (MIC) was tested by using an antibiotic tube dilution method. The structure of the VBC and VCS specimens before and 2, 4, 8, 16, and 40 days after immersion in D-Hank’s was examined by scanning electron microscopy, and the phase composition of VBC was analysed by X-ray diffraction after soaked for 40 days. Thirty-three healthy adult New Zealand white rabbits (weighing, 2.25-3.10 kg; male or female) were used to establ ish the osteomyel itis models according to Norden method. After 4 weeks, the models of osteomyel itis were successfully established in 28 rabbits, and they were randomly divided into 4 groups (groups A, B, C, and D). In group A (n=8), simple debridement was performed; in groups B and C (n=8), defect was treated by injecting VCS or VBC after debridement; and in group D (n=4), no treatment was given. The effectiveness of treatment was assessed using radiological and histological techniques after 2 months. Results The releases of vancomycin from VBC lasted for 30 days; the release rate of vancomycin reached 75% at the first 8 days, then could reached more than 90%. The releases of vancomycin from VCS lasted only for 16 days. The MIC of VBC and VCS were both 2 μg/mL. The VCS had a smooth glass crystal surface before immersion, however, it was almost degradated after 4 days. The fairly smooth surface of the VBC pellet became more porous and rougher with time, X-ray diffraction analysis of VBC soaked for 40 days indicated that the borate glass had gradually converted to hydroxyapatite. After 2 months, the best result of treatment was observed in group C, osteomyelitis symptoms disappeared. The X-ray scores of groups A, B, C, and D were 3.50 ± 0.63, 2.29 ± 0.39, 2.00 ± 0.41, and 4.25 ± 0.64, respectively; Smeltzer scores were 6.00 ± 0.89, 4.00 ± 0.82, 3.57 ± 0.98, and 7.25 ± 0.50, respectively. The scores were significantly higher in group D than in groups A, B, and C (P lt; 0.05), and in group A than in groups B and C (P lt; 0.05). The scores were higher in group B than in group C, but no significant difference was found (P gt; 0.05). Conclusion The VBC is effective in treating chronic osteomyelitis of rabbit by providing a sustained release of vancomycin, in addition to stimulating bone regeneration, so it may be a promising biomaterial for treating chronic osteomyelitis.
ObjectiveTo summarize the clinical application and research status of bioactive glass (BAG) in bone repair.MethodsThe recently published literature concerning BAG in bone repair at home and abroad was reviewed and summarized.ResultsBAG has been widely used in clinical bone repair with a favorable effectiveness. In the experimental aspect, to meet different clinical application needs, BAG has been prepared in different forms, such as particles, prosthetic coating, drug and biological factor delivery system, bone cement, and scaffold. And the significant progress has been made.ConclusionBAG has been well studied in the field of bone repair due to its excellent bone repair performance, and it is expected to become a new generation of bone repair material.
目的 探讨骨髓增生异常综合征（MDS）患者的临床特点。 方法 选取我院2008年3月－2012年10月确诊为MDS的231例患者临床资料进行回顾性分析。患者年龄21～87岁，中位年龄59岁。 结果 231例患者中，难治性血细胞减少伴多系发育异常（RCMD）最多见，占45.0%（104/231）；以贫血乏力症状就诊多见占66.7%（154/231）；血常规中以全血细胞均减少多见占61%（141例/231例）；网织红细胞以正常或增高为主占61%（141/231）；低荧光值增高多见62%（144/231）。乳酸脱氢酶和铁蛋白在各诊断亚型及各国际预后积分系统（IPSS）评分间存在差异，其中乳酸脱氢酶在难治性贫血伴原始细胞增多2型（RAEB-2）中高于综合组：难治性贫血（RA）、 难治性贫血伴环状铁粒幼细胞（RAS）、5q?综合征及RCMD相比较差异有统计学意义（P＜0.05），高危组乳酸脱氢酶高于中危1组及中危2组，其差异有统计学意义（P＜0.05），高危组铁蛋白高于中危1组其差异有统计学意义（P＜0.05），其余差异无统计学意义（P＞0.05）。染色体异常率为39%，其中20例为复杂染色体核型，IPSS评分中危1最多见为52.4%（55/105）。 结论 MDS临床表现多样，缺乏特异性，需综合骨髓涂片、活检、细胞遗传学的结果提高诊断率。